Endodontic Surgery

Endodontic treatment, commonly referred to as root canal therapy, is performed to preserve teeth which have had or are about to have problems with the dental pulp. Often referred to as “the nerve”, the pulp occupies a space in the center of the root of a tooth and may become diseased as a result of dental decay or injury. Non surgical endodontic therapy may be performed by your family dentist or an endodontist (root canal specialist). In most cases this will solve the problem. In some cases, non surgical endodontic therapy is either not indicated or may not be sufficient to correct all the problems associated with a particular tooth. Surgery may be necessary to eliminate or prevent infection from leaking out of the pulp canal and causing damage to the tooth, supporting bone and gums, or even other teeth.

The necessary surgery may be performed painlessly using either local anesthesia, sedation, or general anesthesia, according to what is best for each individual patient. Whichever method of anesthesia is selected, the procedure is painless. Since the problem is usually a point of leakage from the pulp canal, the object of the surgery is to locate the leakage point and seal it. Even with good quality x-rays, this may not be detected. That is why the surgical approach is made under direct vision using high power lighting and magnification. If infection exists, it is treated at this time. Any abnormal tissues, such as cysts or abscesses are removed. In some unusual cases this leakage point may not be easily found and an alternate treatment may become necessary. In the vast majority of cases however, one or more such sources of contamination can be identified and sealed with an appropriate material. Closure of the opening in the gum is made with fine sutures. A postoperative x-ray is usually taken at that time and used as a baseline for future comparison. Follow up visits will determine if the problem has been adequately resolved on a long term basis. Periodic X-Rays are obtained to be sure that healing is complete over time. When additional dental treatment is contingent upon the surgery performed, patients will be advised by our office as to when they may resume treatment.

In some instances, problems which were either not present or not detectable at the time of surgery, may prevent normal healing. Follow up visits afford the opportunity to intercept such problems, should they occur, and treat them accordingly. Typical visits may be spread over one year’s time until all internal and external healing has occurred and the patient may then be completely discharged. Times vary according to individual cases. In a small number of cases, problems such as root fracture may be discovered postoperatively, which makes complete healing impossible. In these cases, removal of the tooth may become necessary.